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General NPI Number Information
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NPI Number | 1750621181
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Entity Type | Individual
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Provider Name | DONALD SWEET SACIT
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Gender | Male
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Dates
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Enumeration Date | 02/21/2013
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Last Update Date | 02/21/2013
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Provider Practice Location Address
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Address Line | 502 E NEW YORK AVE
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City | OSHKOSH
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State | WI
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Zip | 54901-3938
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Country | US
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Telephone | 920-651-1844
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Fax |
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Provider Business Mailing Address
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Address Line | 50 S BUTLER ST
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City | FOND DU LAC
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State | WI
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Zip | 54935-3941
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Country | US
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Telephone | 920-203-4033
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 16694-130
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License Number State | WI
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